SCHIZOPHRENIA

Schizophrenia is a serious mental illness characterised by disturbances in a person’s thoughts, perceptions, emotions and behaviour. However many people diagnosed with schizophrenia, and some professionals, dispute whether there is such a condition.

Schizophrenia is an umbrella diagnosis used to describe a wide range of symptoms. During an episode of schizophrenia, a person may lose touch with reality, see or hear things that are not there, hold irrational or unfounded beliefs, and appear to act strangely because they are responding to these delusions and hallucinations. An episode of schizophrenia can last for several weeks and can be very frightening.

About one in 100 people will have one episode of schizophrenia, and two thirds of these will go on to have further episodes. Schizophrenia usually starts in the late teens or early 20s, but can also affect older people for the first time.

The causes are unknown but episodes of schizophrenia appear to be associated with changes in some brain chemicals. Stressful experiences and some recreational drugs can also trigger an episode in vulnerable people.

Symptoms

Doctors describe two groups of symptoms in people with schizophrenia: positive and negative. Although the positive symptoms are often the most dramatic and, at least initially, the most distressing, the negative ones tend to cause the most problems, as they tend to be longer lasting.

Positive symptoms

The three main positive symptoms are:

• feelings of being controlled by outside forces (ie. having one's thoughts and actions taken over)

• hearing, seeing, smelling or feeling things which are not there (hallucinations)

• irrational and unfounded beliefs (delusions).

The delusions can often be very frightening - the person may believe that others are plotting to kill them or that their conversations are being recorded. Positive symptoms all tend to occur during acute episodes and can be particularly frightening.

Negative symptoms

The negative symptoms include tiredness, loss of concentration, and lack of energy and motivation, which may be exacerbated by the side-effects of drugs used to treat the positive symptoms. Because of these symptoms, people with schizophrenia are often unable to cope with everyday tasks, such as work and household chores. Suicide and self-harm are common in people with a diagnosis of schizophrenia: around one in 10 take their own life.

Treatments

Most people with schizophrenia are prescribed drugs to reduce the positive symptoms. The drugs may be prescribed for long periods and may have unpleasant side effects.

Some people need a great deal of help in managing the symptoms of schizophrenia. Others find ways to cope with experiences such as hearing voices and do not necessarily wish to receive any treatment.

Sometimes, people in an acute phase of the illness may need to be admitted to hospital under the Mental Health Act for their own, or other people's, safety. People with schizophrenia are not usually dangerous to other people; they are more at risk of harm from others, or themselves. Many people who are at risk of relapse carry Crisis Cards or have written up Advance Directives stating how they would like to be treated and what they do and do not find helpful. Mental health professionals do not have to follow these instructions, but it is considered good practice to take the person's wishes into account.

If you, or someone you care for, are experiencing the symptoms of schizophrenia you may wish to contact your GP who can prescribe drug treatments and refer you for psychiatric help. You may also be referred to social services and the local community mental health team who can support you at home.

In an emergency you can go to the accident and emergency department of your local hospital or dial 999. If you are already in touch with your local community mental health team you may want to contact them or your local crisis and home treatment team.